CAD–PACS integration tool kit based on DICOM secondary capture, structured report and IHE workflow profiles

Computer aided diagnosis/detection (CAD) goes beyond subjective visual assessment of clinical images providing quantitative computer analysis of the image content, and can greatly improve clinical diagnostic outcome. Many CAD applications, including commercial and research CAD, have been developed with no ability to integrate the CAD results with a clinical picture archiving and communication system (PACS). This has hindered the extensive use of CAD for maximum benefit within a clinical environment. In this paper, we present a CAD–PACS integration toolkit that integrates CAD results with a clinical PACS.The toolkit is a software package with two versions: DICOM (digital imaging and communications in medicine)-SC (secondary capture) and DICOM–IHE (Integrating the Healthcare Enterprise). The former uses the DICOM secondary capture object model to convert the screen shot of the CAD results to a DICOM image file for PACS workstations to display, while the latter converts the CAD results to a DICOM structured report (SR) based on IHE Workflow Profiles. The DICOM-SC method is simple and easy to be implemented without ability for further data mining of CAD results, while the DICOM–IHE can be used for data mining of CAD results in the future but more complicated to implement than the DICOM-SC method.